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NPI Code Detail

MEDICARE: FATIMA HENRIQUEZ

MEDICARE: FATIMA HENRIQUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1760746044
Entity Type Code : Individual
Provider Name (Legal Business Name) : FATIMA HENRIQUEZ
Provider Business Mailing Address
First Line : 2130 ALLEGIANCE DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-4842
Country : US
Telephone Number : 702-927-6826
Fax Number :
Provider Business Practice Location Address
First Line : 2130 ALLEGIANCE DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-4842
Country : US
Telephone Number : 702-927-6826
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2012
Last Update Date : 07/01/2012

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Directions to “ FATIMA HENRIQUEZ ” Practice Location

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